by Eric Winder, DC   

What’s your glitch? Is it a shoulder that only twinges when you swim backstroke? A knee that is fine except when you’re cycling? A sore hip from the follow-through of a golf swing? Many people have minor physical aches and pains which are exacerbated by athletics. This can reduce activity and performance levels—or even force a hiatus from a beloved sport.  

However, with a detailed assessment, the underlying problem can often be identified and resolved. I’m a fan of careful motion analysis with particular attention to the specific muscles and joints involved. Here are some examples to show what relief is possible with this kind of treatment protocol (names changed for privacy):  

Swimming: 

Betty swam on a regular basis for years, but recently developed limiting pain in both shoulders. She only felt the pain while swimming or raising her arms high overhead. Another knowledgeable swimmer noticed that she used mostly shoulder joint movement to swim instead of a shoulder blade motion. The swimmer coached her to change to the stronger, safer method. This helped but did not resolve the pain.  

I suggested she that she could have built-up restrictions in her fascia (connective tissue) due to years of incorrect swimming form, and those restrictions could still affect her even with the improved stroke. I asked her to demonstrate the motions of this incorrect stroke she had previously used. I detected too much contraction and strain in the infraspinatus muscle on the back of the shoulder blade. Pressing into the muscle, the sensation of fascia restriction was obvious. We released the restriction on both sides with manual therapy, and as a result, Betty’s shoulder pain was greatly reduced. 

Tina was swimming on her high school swim team when she came to my clinic with intense left shoulder pain whenever she swam. Asking her to recreate the motions of her swim stroke showed a problem that occurs in some competitive swimmers—rounded shoulders from only swimming forward strokes which builds the chest and low back muscles, but not the upper back. The round-shouldered posture that results causes narrowing of the space where one of the shoulder tendons runs between bones.  

This makes it possible for the tendon to become pinched when reaching or swimming. Tina learned how to exercise to balance her muscles and stop the shoulder from rounding, and we treated her pectoral muscles for fascia restriction that made the rounding worse. Within four weeks, Tina was swimming without pain.  

Tennis: 

Jerry’s backhand had been causing him shoulder blade pain for about two months, with no apparent cause. He demonstrated his backhand motion for me, and it was clear he was over-rotating his back to compensate for a faulty rhomboid muscle (a muscle connecting the shoulder blade to the spine). Careful examination showed that restrictions in the fascia of some of his rib joints caused the rhomboid weakness. When these were released, the rhomboid was able to work correctly, and his backhand became smooth and pain-free. 

Kim’s felt persistent soreness in in her left hip after playing tennis, and she particularly noticed the pain after serving. On examination of her serving motion, there was a telltale shift in her posture with the downstroke, showing weakness of the psoas muscle that flexes the hip. The weakness was traced to fascia restrictions of the psoas and two other hip muscles, but the psoas became stronger after these were treated with manual therapy. Not only did Kim achieve pain relief, but her serve’s accuracy and speed also increased after treatment.  

Pickleball: 

Let’s examine the most common issue in pickleball—weak lower leg muscles. Pickleball demands ankle strength due to the quick, sudden changes in direction of motion on the court. Ankle sprains, tendinitis and Achilles tendon injuries are common. Most of us don’t use our lower leg muscles much, so many people are not ready for the demands of pickleball.  

Frank had to quit pickleball due to Achilles tendon pain that was aggravated by the sport. During his exam at the office, his ability to hold his ankle rigid while pressure was applied to the foot showed weakness in two directions. This was due to certain weak leg muscles. The weakness traced to restrictions in the fascia of the leg, thigh and lower back. Releasing these restrictions, in combination with exercises to stretch and strengthen his leg muscles, allowed Frank to resume pickleball without pain or worry about his tendon.  

Golf: 

Irene was still an avid golfer in her 80s, but after awhile, was able to control the alignment of the clubface as it struck the golf ball. Suddenly she was hitting the ball in all directions except for where she wanted it to land. She had no pain, but physical therapists found that her right shoulder was weak. However, these efforts to strengthen the shoulder made no change in her wild inaccuracy. When she was referred to my office, her exam included detailed assessment of her golf swing in slow motion.  

It was apparent that weakness in the supraspinatus muscle affected her ability to control her shoulder position on the downswing. Connective tissue restrictions in the fascia of several shoulder and neck muscles were the culprits behind this weakness. Releasing these fascia restrictions restored Irene’s strength and control, and she then returned to hitting tee shots down the middle of the fairway. 

 Every “glitch” that causes performance issues for an athlete is unique to that person. Five people with pain from hitting a tennis backhand might have five completely different causes. For this reason, careful detective work is important. A detailed understanding of joint function and muscle anatomy is important for finding the cause of a problem, but that is not enough. Because each problem is unique, it is important to study the problem by watching the athlete in motion, to see which clues point to the source of the problem.  

Dr. Eric Winder has 24 years in practice with a focus on pain relief and restoration of alignment and motion. He uses fascia release therapies, without forceful manipulation. For more information, visit Gentlebay.com.